Analysis of risk factors for pulmonary infection in adults with newly treated acute leukemia

Objective Tis study investigated the factors influencing the development of pulmonary infections during initial induction chemotherapy in patients with acute leukemia in Yichang area, which has certain guiding significance for the early prevention of pulmonary infection after chemotherapy. Methods This retrospective study analyzed the clinical data and laboratory findings of patients newly diagnosed with acute leukemia, admitted to the Department of Hematology at Yichang Central People's Hospital between September 2018 and November 2023. Risk factors for pulmonary infection and the distribution of pulmonary pathogens were evaluated. Results A total of 251 patients with acute leukemia were enrolled in the study, comprising 62 cases of acute lymphoblastic leukemia and 189 cases of acute myeloid leukemia. Pulmonary infections developed in 200 patients, corresponding to an infection rate of 79.68%. Multivariate analysis revealed that prolonged hospitalization, smoking history, extended duration of agranulocytosis, and failure to achieve complete remission following chemotherapy were independent risk factors for pulmonary infection (P < 0.05). In contrast, prophylactic antibiotic use prior to chemotherapy was identified as a protective factor. Among the 200 patients with pulmonary infections, 51 pathogenic isolates were identified. The distribution of pathogens was as follows: bacteria (39.22%), viruses (34.55%), fungi (20.0%), and Mycoplasma (1.82%). Conclusions In patients receiving initial chemotherapy for acute leukemia, prolonged hospitalization, extended duration of agranulocytosis, failure to achieve complete remission, and a history of smoking were associated with an elevated risk of pulmonary infection. Gram-negative bacteria represented the predominant pathogens. Early identification, timely intervention, and appropriate selection of antimicrobial agents are critical to reducing mortality in this population.